MSH Shares Latest Achievements in Controlling TB at 40th Union Lung Conference in Cancun, Mexico

Twenty MSH experts on tuberculosis (TB) from 15 countries showcased the latest global experience and methodologies at the 40th Union Conference on Lung Health, held December 3-7 2009, in Cancun, Mexico. Organized by the International Union against Tuberculosis and Lung Disease, the meeting featured scientific sessions, workshops, symposia, and poster presentations.

MSH shared experience in and tools for pharmaceutical management for TB, laboratory systems strengthening, and management and leadership of TB programs in several venues, including:

Presentations on country experiences—in Afghanistan, Ethiopia, Ghana, and Malawi—highlighted the results of recent work in scaling up DOTS in urban settings, improving TB/HIV integration, reducing mortality from TB, improving case detection, and strengthening systems such as laboratories and monitoring and evaluation.

Progress in Afghanistan

In the symposium “Afghanistan: Achievements and Challenges of the National TB Control Program in a War-torn Country,” three representatives of the National TB Control Program of Afghanistan and MSH/TB CAP discussed progress in and the challenges of controlling TB in an insecure environment. They pointed to achievements that include expansion of the number of health facilities providing DOTS, from 10 in 2000 to 1,030 in 2008. Case notification rose from 9,668 in 2001 to 28,301 in 2008. During the same period, case detection increased to 73 percent, while treatment success is now 89 percent.

Dr. Khaled Seddiq, National TB Program Manager, mentioned three factors that underlie this success: the leadership of Afghanistan's Ministry of Public Health, strong coordination and collaboration with donors and partners, providers’ motivation, and good knowledge of TB. 

Dr. Mohammad Rashidi, TB CAP Team Leader from MSH, pointed out that a network of 25,000 community-based health workers (CHWs) provides “strong linkages between community and facility,” and there is “very strong community leadership—people in village health shuras (committees) are all trained.” Rashidi continued, “The CHWs are the health ministers of the village. . . .they are selected and trusted by the community.” This trust is illustrated by the fact that “67 percent of all family planning materials are distributed by health workers.” 

Staff of the World Health Organization, US Agency for International Development, BRAC, and MSH participated in the lively question-and-answer session that followed. Dr. Seddiq. Dr. Rashidi, as well as Dr. Sayed Dayoud Mahmoodi, spoke about security problems, human resources for health and the challenge of high turnover—due in part to low salaries in the public sector—and the high number of TB cases among women. 

The importance of partnerships and the integration of TB into the Basic Package of Health Services emerged as essential elements. Finally, education through activities and information distributed at schools, universities, and Friday prayers and on the radio is helping to change the stigma that surrounds TB. For example, in Afghanistan more than 6 million students marched on World TB Day in support of those infected with and affected by TB, Siddiqi noted.  

These experiences correspond with the theme of the conference, poverty and lung health. The global financial crisis, which has increased poverty and strained health systems around the world, makes it more important than ever to work together to find integrated, efficient, and sustainable ways to address TB. 

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